Maeda Yoshinori, Yamakawa Jin, Sakamoto Yoko, Miyazaki Keiko, Katsuki Shiho, Miyagawa Yoshikado
Department of Anesthesiology, Saiseikai Futsukaichi Hospital, Chikushino 818-8516.
Masui. 2013 Aug;62(8):979-81.
Perioperative management of a spinocerebellar ataxia patient by epidural anesthesia is reported. A 67-year-old woman with left femur neck fracture underwent femoral head replacement. An epidural catheter was placed without difficulty at the L3-4 interspace using the loss of resistance technique. A total of 1% mepivacaine 13 ml was administered in divided doses to obtain bilateral T5 analgesic level. Hypotension (79 mmHg systolic) was observed transiently, and ephedrine 8 mg was administered which successfully elevated blood pressure. Overall, hemodynamics and respiratory status were stable. Postoperative analgesia was maintained by infusion of 0.2% ropivacaine at 2 ml x hr(-1). The patient's postoperative course was uneventful, and her neurologic conditions remained unchanged.
报告了1例脊髓小脑共济失调患者行硬膜外麻醉的围手术期管理情况。一名67岁左侧股骨颈骨折女性接受了股骨头置换术。采用阻力消失技术于L3-4间隙顺利置入硬膜外导管。分剂量共给予1%甲哌卡因13 ml，以达到双侧T5镇痛平面。短暂观察到低血压（收缩压79 mmHg），给予麻黄碱8 mg后血压成功回升。总体而言，血流动力学和呼吸状态稳定。术后通过输注0.2%罗哌卡因2 ml·h-1维持镇痛。患者术后恢复顺利，神经状况未变。
